Physicians group criticizes JPS for on-site McDonald’s

Fort Worth’s John Peter Smith Hospital may have turned smoke-free starting this month as part of its health initiative, but you can still get a Big Mac with fries there.

JPS is one of 43 hospitals — seven in Texas and the rest mostly in the South — that have a McDonald’s, Wendy’s or Chick-fil-A inside, according to a report by the Physicians Committee for Responsible Medicine, a Washington, D.C., health advocacy group.

“Hospitals that have contracts with fast-food chains create a conflict of interest,” the report said. “They profit by encouraging patients, employees and visitors to eat the very foods —loaded with saturated fat and cholesterol — that hospitalize millions of Americans every year with complications from obesity, diabetes, heart disease, and other chronic diseases.”

Nine hospitals, including Parkland Memorial in Dallas, have dropped their fast food outlets in recent years, the Physicians Committee report said, citing its own efforts as influencing these decisions by shedding light on the issue. Another group, Corporate Accountability International, has also lobbied hospitals including JPS to drop fast food.

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JPS renewed its contract with McDonald’s in 2013, but made several stipulations in the contract, including an upgraded venue and healthier food preparation and options, said Jill “J.R.” Labbe, spokeswoman for the hospital.

“McDonald’s now uses interior signs featuring the healthiest options; for example, the oatmeal with fresh fruit or a fruit parfait made with low-fat yogurt, a chicken snack wrap with fresh spinach, a Southwest salad, chicken noodle soup,” she said. “Also, every item on the order boards includes the caloric intake, and the chicken items have the option of crispy or grilled.”

Labbe also said the noncompete clause in the previous contract was taken out, which allows the JPS gift shop to carry healthy snacks and microwave meal options. The current contract also has a 270-day notice that JPS can take over the space, she said.

Regardless, having a fast food chain like McDonald’s conflicts with a hospital’s mission, said Rebecca Dority, a registered dietician who is on the faculty at Texas Christian University.

“Unfortunately, though there are often healthier menu options at fast food restaurants, many of the menu items are incompatible with the hospital’s mission,” she said via email. “Increased marketing of healthier menu options, limiting menu options to include items that meet certain nutrient standards and prohibiting meal delivery to patient rooms could be useful tools to help align the hospital’s goals with that of the contracted food service organization. Ideally, it would be beneficial for these hospitals to contract with fast casual restaurants whose entire menu is more consistent with the mission of the hospital.”

The Physicians Group report also looked at hospital food itself, but it only received menus back from six public hospitals through its open records requests. JPS was one of the hospitals that responded, earning them a spot in the report.

JPS received a grade of “D” from the group on the nutritional value of its menu for cardiac patients, citing flank steak and Swedish meatballs among its unhealthy choices. A nutritionist with the group said that all meat and dairy products should be eliminated from a cardiac patient’s diet and that just 68 percent of the foods on a one-week menu for the cardiac unit at JPS had healthful, high-fiber, no-cholesterol foods.

However, the hospital did not give the advocacy group its full cardiac menu, which includes fish and bean options, vegan wraps and vegan patties, Labbe said. The hospital complied with the group’s open records request, which was not specific, she said.

In addition, JPS’ cardiac patient menu complies with recommendations of the American Heart Association and the Academy of Nutrition and Dietetics, which includes limits on sodium, cholesterol, saturated fats and total fats, Labbe said.

“We try very hard to make our food as tasty as possible even for patients on cardiac and diabetic diets because one of the keys to recuperation is adequate nutritional intake,” she said. “Our clinical staff measures the amount of food our patients eat at each meal. If the food isn’t appealing, patients won’t eat it and we wouldn’t be doing all we can to assist in recovery so they can go home.”

TCU’s Dority agrees that taste and nutrition must go hand in hand for a patient to heal properly.

“A plant-based diet can be low in fat and cholesterol with the added bonus of increased vitamins, phytochemicals and fiber,” she said. “It is possible, though, to incorporate low-fat meats and dairy and stay within the recommended 300 mg cholesterol per day limit.”

Offering plant-based menu items as an alternative, instead of exclusively, could provide the benefit of introducing patients to unfamiliar foods, she said.

“Ultimately, the goal is to provide nutritional counseling on long-term dietary modifications that can be made once the patient is home, including ways to incorporate more plant-based, nutrient dense foods,” she said.